As a stage 4 HER2+ patient I regularly have my tumor marker test done. My marker is within range but has never gone to single digits, I am in the teens and 20s on the CA27.29. I had a complete pathological response to taxotere, Herceptin, and perjeta after 6 cycles and still receive HP every three weeks. No surgery or radiation though. Curious to know about others' tumor markers.

I had my tumor markers tested when I was originally diagnosed in Aug 2013. My CA 27.29 was 38.8 normal should have under 38.6. So even though I had extensive cancer in my breast and nodes, I was only slightly higher than normal. I also had CEAB test which was 1.1. Normal should have been under 2.5 so I was within the normal range.

My CA 29-27 have always been normal. My CEA is currently 149 should be below 4, and my CA125 is 330+
We are all so different. Did you test positive for CEA or CA125 on your pathology report? If you did, they are probably good markers.

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Breastfeeding when diagnosed with Her2+ May 2008
Oct 2008 Double mastectomy 22/28 lymph nodes positive
Decline chemotherapy (decision I regret)
Nov 2009 Mets to lungs and bones.
Dec 2009 Start Taxotere and Herceptin, T1, T3 heal completely and lungs are clear, T2 and first rib have lytic lesions. First rib becomes sclerotic. Considered stable.
May 2011, Onc calls progression and I cross over from comparison arm of clinical trial to TDM-1
Brain scan in Sept 2011 showed small tumor in right cerebellum, did Novalis radiation.

Feb 2013 < 1cm tumor in left frontal lobe. Did Novalis in March and latest scan shows no sign of brain metastasis.
Aug 2013 did 36th round of TDM-1 Due to TDM-1 side effects, shortness of breath, and difficulty getting my balance when getting out of bed, agreed with my oncologist to stop TDM-1.
Took a six week break, bone scan showed small uptake on left first rib. CT showed hypodensities in liver (too small to biopsy) and small nodule in lungs (mediastinal).
Started Navelbine weekly. Did one round with Herceptin.
Skipped next 2 rounds, due to neutropenia. Next chemo 7th Nov - have had 3 Neupogen shots, so WBC should look better... Did not tolerate Navelbine well.
December 2013 scans show no sign of active cancer.
March 2014 - currently only on Herceptin - brain MRI clear, PET/CT two nodules in right lung show uptake
May 2014 - stop Herceptin.
Sept 22, 2014 Brain MRI clear :) PET/CT Progression in lungs.
Sept 2014, Xeloda, Tykerb and Herceptin.
Nov 2014 - Decide to take a break from all treatment.
May 2015 - Brain met radiated with Novalis
July 2015 - Have progression in right lung.
Sept 2015 - Perjeta and Herceptin alone after a 9 month break from all treatment.
Nov 2015 - Thoracentesis 1500ml removed from right lung.
Dec 2015 - Two tiny 1mm brain mets radiated in right cerebellum.
Feb 2016 - Thoracentesis 2200ml drained from right lung
Feb 2016 - Stopped Perjeta and Herceptin and started back on Kadcyla as I had no previous progression on it. After 1 cycle of Kadcyla markers begin to drop. On second cycle add Keytruda.
March 2016 - Thoracentesis 1650ml drained from right lung.
April 2016 – Thoracentesis 1500 ml drained from right lung.
June 2016 – CT scan shows progression in right lung, as well as moderate pleural effusion requiring Thoracentesis.
June 2016 – Decide to stop Keytruda, and will do chemosensitivity test through Rational Therapeutics. Plan to continue on Kadcyla for next two cycles.
July 2016 - Start weekly Abraxane with Herceptin. WBRT with hippocampal sparing, Taking Namenda. 15 sessions over 3 weeks.
Aug - Dec 2016 - 2 infusions of Navelbine, very hard on my body and still dealing with anasarca (generalized edema) 1 infusion of Havalen
My doctor wants to put me on hospice.
Dec 23rd 2016 - I am granted compassionate use of Neratanib.
May 31st 2017 - still on Neratinib, feeling good.

After reviewing my pathology report I do not see any CEA or other tumor type test outside of estrogen, progestin and HER2. Tumor markers were done with following blood work after biopsy. Sometimes I feel so "ignored" by my onc. She is highly recommended and regarded in the cancer community here but I have so many questions she has never answered.

Proteomics allows for better understanding of the function and regulation of cancer cells mediated by intra- and extracellular signaling networks. Integrating such information with clinicopathological characteristics of the tumor may lead to either detection of disease biomarkers useful to differentiate high-from low-risk patients, or to identification of new drug targets. Adjuvant chemotherapy is currently a personalized treatment strategy, especially for breast cancer (BC) patients, and the risk assessment of each patient influences its use because the benefit strictly correlates with the level of risk. Luminal A BCs are endocrine therapy (ET)-sensitive but exhibit low sensitivity to chemotherapy, while luminal B cancers, according to the Ki-67 proliferation rate may require for chemotherapy in addition to ET, and HER2-positive tumors derive benefit from adjuvant chemotherapy containing an anthracycline, a taxane and trastuzumab for one year. Triple-negative BCs have a high degree of genomic instability exhibiting a more aggressive clinical course with respect to other types of BC, and the anthracycline-taxane regimen constitutes the standard approach. Studies considering the use of targeted approaches (drugs), including poly (ADP-ribose) polymerase (PARP-1), vascular endothelial growth factor (VEGF), epidermal growth factor receptor (EGFR) inhibitors, or EFGR and HER2 blockers, are still under evaluation. In the genomic era, promising new targeted-therapies are worthy of further investigation, and mTOR inhibitors have been used for patients with high-risk ER-positive and HER2-negative tumors. In the near future, genetic and molecular profiling of BC will help to better-categorize patients, determine the choice of chemotherapy in low-risk, or intensify the treatment in high-risk cancer patients, eventually revealing new targeted agents.

Wanted to update my previous response. My radiation onc recently ordered a ca27.29 test for me. It is currently 6.1. As stated previously, it was 38.8 before treatment. I guess this means that ca27.29 is a good test for me?

Colleen,
I see that you had a complete pathological response to treatment. I'm wondering what tissue was removed for the pathologists to determine you had a complete response? Did you have axilla dissection?

The only tissue collected was from my breast. My oncologist and surgeon relied on PET/CT scans, MRI, and another biopsy after the six cycles with taxotere were completed. We continue with PET/CT scans every six months, bloodwork every three weeks, physical exams every six weeks, and 3D mammograms yearly. Add to that the other medical specialists that I see on a regular basis. Sometimes I think my social calendar revolves around doctor appointments.

Colleen,
Thanks for answering my question regarding pathological complete response (PCR). I also had a PCR in my breast tissue and in the sentinel lymph nodes. It is good to know that so many of us have such a good response to treatment.

My oncologist never tells me what my tumor markers are because he says they can be unreliable. I really don't care I would rather know what they are. He can be evasive in responding to other questions as well. And, though I had the full regimen of docetaxol, carboplatin, Herceptin, and Perjeta, my large tumor only shrank by half and my very tiny tumor did not go away. I had neoadjuvant chemo followed by a mastectomy so that is why I know details of size of tumors after treatment. My cancer's response leaves be concerned.

My 27/29 tumor marker test was around 124 at dx, dropped to 54 at the end of my 6 cycles with THP, still on herceptin and perjeta and it hovers in the teens to low 20s. Stage IV at dx but have been NED for two years. Last 27/29 was done in March, it was 18. It's a good test but not a perfect indicator.

My CA 15-3 has always been between 14-22 (since March, 2000). Higher during chemo. However, on the day I was officially diagnosed with a new primary in the other breast (still doubting if it was a new primary;-), my CA 15-3 was 17.

I've asked my onc why she keeps prescribing this test since it is obviously not a good marker for me and haven't received a satisfactory answer yet. This is the only tumor marker test I've been given.

My onc says tumor marker blood tests of any kind are not a perfect indicator of cancer being present. I get the ca 27/29 every 9 weeks and scans every 6 months now. A good question to ask when I see her a week is: if the tumor marker test is not an ideal indicator why do we do them every nine weeks, what's the science behind it?